After Years of Increases, Global HIV/AIDS Funding Declines in the Midst of Economic Recession

For the first time in fifteen years, global commitments to fighting HIV/AIDS are faltering according to the executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), Michel Sidibé.[1] This comes at an inopportune time for one of the largest funders of AIDS programs, the Global Fund to Fight AIDS, Tuberculosis and Malaria, which is currently facing its 2011–2013 replenishment cycle. At the end of October, donor organizations and nations will have made commitments that determine the Global Funds financial resources for the next three years. Though the organization hopes for US$20 billion to meet expected demand, a recent publication containing budget proposals anticipates less, outlining three different scenarios based on total contributions of $13, $17, and $20 billion.[2]

While dismaying, this news comes as little surprise considering the global economic recession. An early indicator was a report coauthored by the Kaiser Family Foundation and UNAIDS that found that the total international expenditure on AIDS relief has recently plateaued. In 2009, donor countries gave $7.6 billion international expenditure, which was essentially the same amount contributed in 2008 ($7.7 billion).[3] In July 2010, attendants of the 18th International AIDS Conference, in Vienna also expressed their apprehension at the declining financial support. United Nations Secretary General Ban Ki-moon noted, “Some governments are cutting back on their response to AIDS . . . a cause for great concern to us all.”[4]

The financial crisis is not only affecting the availability of resources, but has also altered where funds are directed. According to the Wall Street Journal, donors are starting to focus more aggressively on prevention due to the high cost of treating those already infected with HIV/AIDS.[5] Yet even the most promising preventative methods are falling short on cash. A microbicidal vaginal gel developed in South Africa is about $42 million short of the $100 million needed for further research; this despite recent trials that have shown the gel to effectively reduce the risk of contracting HIV by 39% overall compared to the placebo, while women who used the gel most regularly could reduce their odds of infection by 54%.[6]

Though human lives are what essentially lay on the line, continuing HIV/AIDS funding is also financially smart. “[Preventing HIV/AIDS] is not a program that is taking money away,” HIV/AIDS specialist Peter Mugyenyi points out; “it is saving huge amounts of money.”[7] In some parts of the world, the long-term cost from budget cuts is already emerging. In Uganda, newer and greater incidences of drug-resistant HIV are appearing after antiretroviral shortages have led to erratic or discontinued treatments for infected individuals.[8]

“It is imperative to continue funding HIV/AIDS programs at a consistent rate,” comments Jen Heitel Yakush, director of public policy for the Sexuality Information and Education Council of the United States (SIECUS). “Hesitating at such a crucial time in the fight against HIV/AIDS is ill-advised. Holding back not only costs lives today, but is exponentially more damaging for the future.”

[3] Jennifer Kates et al., Financing the Response to AIDS in Low-and Middle-Income Countries: International Assistance from the G8, European Commission and Other Donor Governments in 2009 (Menlo Park, CA, and Geneva: Kaiser Family Foundation and UNAIDS, July 2010), accessed 15 September 2010, <http://data.unaids.org/pub/Report/2010/20100718_funding_report_en.pdf>, 2.